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> These ratings are not great because they incentivize doctors not to take more complex cases.

This reminds me of a scene in the recent Dr. Strange movie where the main character -- a neurosurgeon -- turns down a case because it had a high risk of failure and he didn't want to tarnish his perfect record.

> They claim to be risk-adjusted, but in reality you cannot adjust for all possible risk factors. Lots of things in medicine are very unique. There's very little that's more complex than human disease.

Isn't it better to approach the problem by improving how we do these risk assessments so that the risk-adjusted ratings are fair, as opposed to leaving patients in the dark about where to get the best care?




It's hard to just "improve the risk adjustments." The statistics aren't there.

I agree patients shouldn't be left in the dark. The most important thing is getting the best care. There isn't an easy solution.

However, I think the existing solution hurts patients (and I have seen these risk assessments first-hand numerous times).


It reminds me of a relative who couldn't find a surgeon for his problem, because the first 2 thought he was a risky patient. Then the 3rd charged more.

And thinking about it, I realized how many projects I jumped in while others jumped out because, you know, they were risky in not succeeding...




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